Tapas Mukherjee is also a Respiratory Registrar and Education & Leadership Fellow at Leicester Royal Infirmary

Welcome back to Futures, Tapas.

It’s been just over a year since we last spoke when you were riding high on the success of your asthma management video ‘Breakfast at Glenfield’. You’ve just launched a second film, ‘Inhaler Blues’. Tell us how they differ and what your previous experience taught you.

Dancing Doctor | The Inhaler Song #InhalerBlues

The first film opened my eyes to how much love there was in medicine for something a bit different! As medics we are constantly told that we must do things a certain way – because otherwise there are punishments. I flipped that thinking round by presenting the learning as something fun. This led to doctors and nurses doing the right thing because they wanted to, not because they had to.

To get somewhere in the NHS with projects like mine you have to learn how to talk about saving money, business cases, risks and benefits. One of the greatest missed opportunities of our training is that we aren’t taught how to do any of this, and I fear that generations of junior staff’s good ideas go to waste because they aren’t equipped with the tools to give them a voice in the NHS.

That’s probably one of the amazing things about ‘Breakfast at Glenfield’ and social media – it gave me a voice that transcended the boundaries of my ward, hospital and even country, and made news around the world.

The second film, Inhaler Blues, is different in that it makes the bold step of being aimed at the public.

What motivated you to create Inhaler Blues and what difference are you trying to make?

The ‘Breakfast at Glenfield’ video reached 80,000 views and a lot of people thought it was a fluke, or perhaps something that shouldn’t be held in as high regard as other, more academic medical achievements. I disagree with this mindset. We shouldn’t only reward one type of achievement in medicine. I agree that it’s exciting to read about new wonder drugs, but how many of our patients fully understand how to use their inhaler? How many do we actually communicate with in a way they understand?

One of the motivations behind the new video came from reading the National Review of Asthma Deaths report in 2014. It showed us how little understanding some patients have of their inhalers and asthma, to the extent that many people died from an asthma attack at home and didn’t even call for an ambulance. I hope to change that with this video, by educating the public on the dangers of under treated asthma.

One of the motivations behind the new video came from reading the National Review of Asthma Deaths report in 2014. It showed us how little understanding some patients have of their inhalers

If we can reach 250,000 people with ‘Inhaler Blues’, and loosely say that 1 in 10 of the population have asthma and use an inhaler, that means 25,000 people with asthma will see the video.

As a conservative estimate, an acute asthma admission costs the NHS £3,000, so for every one person who learns from this video, the savings quickly add up.

In addition to this, many people watching will subsequently see their GP or nurse - something which is encouraged in the video, in line with the NRAD report and the latest version of the BTS/SIGN asthma guideline - and switch to a better inhaler, which will hopefully cut down on inappropriate salbutamol prescriptions too, saving more money.

What were the biggest challenges this time around and, similarly, have you had to make any sacrifices, personally or professionally?

I have invested a lot of time and money to the project, and at times the process has been incredibly slow and frustrating.

I first filmed this video in 2014 and since then there has been a lot of meetings and forms to fill in to sign off the content. I underestimated how long the process would be and how I’d need to raise more money than first anticipated to get it finished.

To make sure I could continue working the video and getting promoted around the country I dropped my full time registrar job to work part time. It also tied in with the birth of my son which means my family has felt the financial impact of a reduced salary even more. With my wife on maternity leave we’ve had to cut back to make things more affordable, like selling our car.

On a positive note, it means that I now have the backing of large organisations and big names, including my own Trust (University Hospitals of Leicester), Education for Health, Mark Levy (the author of the NRAD report), and NHS England.

I agree that it’s exciting to read about new wonder drugs, but how many of our patients fully understand how to use their inhaler?

Another big breakthrough was when NHS England started a new fellowship called The Clinical Entrepreneur Scheme. It is perfect for people like me who up to this point have been labelled as a bit odd because we have ideas that don’t fit into conventional NHS training jobs. I was successfully appointed to it earlier this year and it really helps with credibility, networking and growing my ideas.

Last year you weren’t sure you’d consider yourself to be an ‘innovator’ yet. Do you see yourself as one now and, if so, do you have any advice for similarly entrepreneurial respiratory clinicians?

This year I am more confident about calling myself an innovator: Einstein once said ‘if at first the idea is not absurd, then there will be no hope for it’. I identify with that! After learning how to express myself and work with the system I am now in a position where I can pursue those ideas and hopefully improve the lives of hundreds of thousands of patients along the way.

Tell us more about your imminent role as NHSE Innovation Fellow as part of their clinical entrepreneur scheme.

NHS England have supported me at every step with the new video. I am delighted to have been offered this role with NHS England; it means that following the release of the new video I will have access to the world class advice in the form of their mentors and a valuable network of health organisations around the country. It also provides a credible title that all of my video work now sits under. The NHS is such a respected organisation worldwide, that being able to say I am doing this as part of the NHS England Fellowship is incredible.

Einstein once said ‘if at first the idea is not absurd, then there will be no hope for it’. I identify with that!

In terms of this video, what will success look like?

Measuring success is fundamental to this project so I will also be linking to a survey that viewers can fill in after watching the video.

The survey will use the Asthma Control Questionnaire questions at baseline and again after 6 weeks to determine whether those who do engage with the messages in the video actually improve their asthma control too.

Who is your target audience and how can colleagues help you to target them?

I know from the first video that most viewers were female, and aged around 25-35, but I think my target this time is everyone from teens upwards.

Asthma affects people of all ages therefore people from all walks of life could benefit from seeing it. Interested colleagues can help by sharing it themselves on social media, and even better would be for GP practices to play it in waiting rooms.

Once a precedent for producing innovative videos is set, it breaks down people’s perception of it being risky

The support of organisations like Asthma UK who can promote it directly to patients would be fantastic. Their backing and influence over patient health could make a massive difference to the success of this project.

I’m sure the public will value Inhaler Blues; do you see it being used in a clinical setting too? Could you license it for hospital – and possibly also general practice - use in the near future?

Making future videos in a sustainable way is really important. It’s up to me to prove this method of patient education is a sensible use of money. At that point I will be in a stronger position to license future videos to hospitals and other organisations.

Once a precedent for producing innovative videos is set, it breaks down people’s perception of it being risky and instead that it’s effective and can save them money. I can’t wait for people to see it.